Chapter 25

 Structure and Function  Subjective Data—Health History Questions  Objective Data—The Physical Exam  Abnormal Findings Sli de 25- 2

 Usual bowel routine  Change in bowel habits  Rectal bleeding or blood in the stool  Medications (laxatives, stool softeners, iron)  Rectal conditions (pruritus, hemorrhoids, fissure, fistula)  Family history  Self-care behaviors (diet of high-fiber foods, most recent examinations) Sli de 25- 3

 Preparation ◦ Position  Equipment needed ◦ Penlight ◦ Lubricating jelly ◦ Glove ◦ Guaiac test container Sli de 25- 4

Inspection of the Perianal Area  Skin  Anal opening  Sacrococcygeal area  Valsalva maneuver Sli de 25- 5

 Pilonidal cyst or sinus  Anorectal fistula  Fissure  Hemorrhoids  Rectal prolapse  Pruritus ani Sli de 25- 6

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 Abscess  Rectal polyp  Fecal impaction  Carcinoma Sli de

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 Benign prostatic hypertrophy (BPH)  Prostatitis  Carcinoma  Abscess  Rectal polyp  Fecal impaction  Carcinoma Sli de